Mental Wellness Self-Care in Singapore With mindline.sg: A Tutorial on the Development of a Digital Mental Health Platform for Behavior Change.

BACKGROUND: Singapore, like the rest of Asia, faces persistent challenges to mental health promotion, including stigma around unwellness and seeking treatment and a lack of trained mental health personnel. The COVID-19 pandemic, which created a surge in mental health care needs and simultaneously accelerated the adoption of digital health solutions, revealed a new opportunity to quickly scale innovative solutions in the region. OBJECTIVE: In June 2020, the Singaporean government launched mindline.sg, an anonymous digital mental health resource website that has grown to include >500 curated local mental health resources, a clinically validated self-assessment tool for depression and anxiety, an artificial intelligence (AI) chatbot from Wysa designed to deliver digital therapeutic exercises, and a tailored version of the website for working adults called mindline at work. The goal of the platform is to empower Singapore residents to take charge of their own mental health and to be able to offer basic support to those around them through the ease and convenience of a barrier-free digital solution. METHODS: Website use is measured through click-level data analytics captured via Google Analytics and custom application programming interfaces, which in turn drive a customized analytics infrastructure based on the open-source platforms Titanium Database and Metabase. Unique, nonbounced (users that do not immediately navigate away from the site), engaged, and return users are reported. RESULTS: In the 2 years following launch (July 1, 2020, through June 30, 2022), the website received >447,000 visitors (approximately 15% of the target population of 3 million), 62.02% (277,727/447,783) of whom explored the site or engaged with resources (referred to as nonbounced visitors); 10.54% (29,271/277,727) of those nonbounced visitors returned. The most popular features on the platform were the dialogue-based therapeutic exercises delivered by the chatbot and the self-assessment tool, which were used by 25.54% (67,626/264,758) and 11.69% (32,469/277,727) of nonbounced visitors. On mindline at work, the rates of nonbounced visitors who engaged extensively (ie, spent ≥40 seconds exploring resources) and who returned were 51.56% (22,474/43,588) and 13.43% (5,853/43,588) over a year, respectively, compared to 30.9% (42,829/138,626) and 9.97% (13,822/138,626), respectively, on the generic mindline.sg site in the same year. CONCLUSIONS: The site has achieved desired reach and has seen a strong growth rate in the number of visitors, which required substantial and sustained digital marketing campaigns and strategic outreach partnerships. The site was careful to preserve anonymity, limiting the detail of analytics. The good levels of overall adoption encourage us to believe that mild to moderate mental health conditions and the social factors that underly them are amenable to digital interventions. While mindline.sg was primarily used in Singapore, we believe that similar solutions with local customization are widely and globally applicable.

SARS-CoV-2 among the Potential Viral Triggers for Vogt-Konayagi-Harada Disease: First Case Report and Literature Review.

OBJECTIVE: To describe a case of Vogt-Koyanagi-Harada (VKH) disease associated with the novel coronavirus disease 2019 (COVID-19). MATERIALS AND METHODS: A retrospective review of patient records was carried out to obtain data for a case report. A literature review was conducted of cases of uveitis associated with COVID-19 reported to date. CASE DESCRIPTION: A 32-year-old Hispanic female presented with bilateral granulomatous panuveitis consisting of VKH disease 2 weeks after a clinical course of COVID-19. Both eyes presented with anterior uveitis and edematous hyperemic papilla with flame-shaped peripapillary hemorrhages, macula-off serous retinal detachments with subretinal fluid, and vitritis. A complete systemic work-up was performed to exclude infectious or inflammatory etiologies. Ocular inflammatory signs and systemic symptoms improved with corticosteroid and immunomodulatory therapy. CONCLUSION: SARS-CoV-2 can be a potential immunological trigger for VKH disease. Patients presenting with panuveitis and a history of a previous flu-like illness should raise clinical suspicion of the presence of SARS-CoV-2 in the context of the ongoing global pandemic.

Características clínicas y epidemiológicas de los pacientes atendidos por trauma ocular en Panamá / Clinical and epidemiological characteristics of patients treated for ocular trauma in Panama

Objetivo: Describir las características clínicas y epidemiológicas de los pacientes atendidos por trauma ocular en el cuarto de urgencias por el Servicio de Oftalmología del Complejo Hospitalario Dr. Arnulfo Arias Madrid, desde junio de 2018 a marzo de 2020. Metodología: Estudio descriptivo, no experimental, retrospectivo, de corte transversal, se obtuvieron los datos de las variables correspondientes a la totalidad de los pacientes atendidos en el cuarto de urgencias por el servicio de oftalmología del área y periodo de estudio. Resultados: Los traumas en el hogar (45.1%) fueron el área más común, seguido por el puesto de trabajo (39%). Los agentes causales fueron objetos contusos (42%), objetos punzocortantes (19%) y quemaduras químicas (18%). Presentamos un alto índice de objetos vegetales (36%) y madera (12%), lo cual podemos asociar a la alta incidencia de queratitis fúngicas en Panamá. Respecto a la agudeza visual inicial del trauma, el 66.8% tenían una agudeza visual corregida de 20/50 o mejor y un 24.3% de 20/120 o peor. Conclusiones: Podemos concluir que la población más afectada son varones entre la 3.ª y 4.ª década de la vida económicamente activa, provenientes del área urbana, principalmente en el área laboral de la construcción y agropecuaria. Causados por objetos contusos y punzocortantes

Objective: To describe the clinical and epidemiological characteristics of patients treated for ocular trauma in the emergency room by the ophthalmology service of the Complejo Hospitalario Dr. Arnulfo Arias Madrid. From June 2018 to March 2020. Methodology: Descriptive, non-experimental, retrospective, cross-sectional study, the data of the variables corresponding to all the patients treated in the emergency room by the Ophthalmology service of the area and study period were obtained. Results: Traumas in the home (45.1%) were the most common area, followed by the workplace (39%). The causal agents were blunt objects (42%), sharp objects (19%) and chemical burns (18%). We present a high rate of vegetative objects (36%) and wood (12%). Which we can associate with the high incidence of fungal keratitis in Panama. The initial visual acuity of the trauma, (66.8%) had a corrected visual acuity of 20/50 or better and (24.3%) of 20/120 or worse. Conclusions: We can conclude that the most affected population are men between the 3rd and 4th decade of economically active life, coming from the urban area, mainly in the construction and agricultural labor area. Caused by blunt and sharp objects

Young people have their say: What makes a youth-friendly general practice?

BACKGROUND: The health of young people can be considered an indicator of the health of Australia's future population. To improve access to healthcare, the perspectives of adolescents on the design and delivery of services need to be championed. The objective of this study was to identify what young people in north-west Tasmania value when seeking healthcare at general practices. METHODS: The study was conducted at a single high school in rural Tasmania. Students aged 16-18 years were invited to participate in an electronic survey seeking their views and preferences for presenting to their general practitioner (GP). RESULTS: One hundred and fifty-five students, with a mean age of 17 years, were surveyed. GPs were the usual healthcare providers for 98.4% of participants, and 86% stated that they would like to discuss mental health, substance use and sexual health with their GP. DISCUSSION: GPs can improve access to care for young people through good communications skills and treating young people as young adults.